Background

The Opportunity

CDC is the nation’s leading public health agency, dedicated to saving lives and protecting the health of Americans. CDC field staff work in all 50 states, 8 U.S. territories, and more than 50 countries.

In 2010 CDC took the opportunity to evaluate where we could make the greatest impact for the most Americans. It was not unusual for CDC to set public health priorities that could be addressed in a meaningful way during a clearly defined timeframe. These priorities are often established in support of Department of Health and Human Services (HHS) and White House initiatives. CDC’s priorities are often based on the scope of the health problem, the ability to have significant health impact, and the ability to address health costs.

But the idea of “Winnable Battles” took setting priorities and creating synergy to a new level. The initiative focused on several high-burden areas with known, effective, evidence-based strategies where progress could be made in a relatively short timeframe.

“Winnable Battles” describe public health priorities where CDC and public health can make significant progress quickly—generally within one to four years. For an agency as large and diverse as the CDC, the idea of a highly focused set of priorities, or battles, which could be reexamined with senior leadership support to accelerate progress, was enticing but also complex.

The Initial Challenges

Identifying a handful of issues as “Winnable Battles” may have come across as diminishing the important work that fell outside the “Winnable Battles” arena. It had to be made clear that the “Winnable Battles” designation did not validate or invalidate ongoing work. Rather, the designation served as a catalyst for accelerating progress, and creating that understanding in the agency was critical. CDC’s intent was to bring additional attention to these critical health issues and rally diverse resources and partnerships (both internal and external) to accelerate measurable health impact.

The Criteria

The Winnable Battles concept was borne out of the desire to improve the health and safety of the nation as quickly as possible for as many as possible. A Winnable Battle had to be a health issue of high concern. It carried a significant burden, affected many people and incurred considerable costs. Known, effective strategies existed that could be employed to help lessen the burden. Winnable Battles was not a research initiative or a discovery process, but a reframing of issues by focusing on the most impactful priorities.

The Choices

Six initial programs were identify as Winnable Battles: tobacco; nutrition, physical activity, obesity, and food safety; healthcare-associated infections (HAIs); motor vehicle injuries; teen pregnancy; and HIV in the U.S. These areas were selected because they presented the following opportunities:

They addressed public health priorities that have a large-scale impact on health.

Evidence-based interventions existed to address the issue and could be broadly implemented.

Intensive focus and efforts could have a significant impact in a relatively short period of time.

These six areas varied in size, funding mechanisms, and budgets. Some had been a focus of CDC’s for decades. Some were led by other agencies who had more funding and a greater voice on the issue and the CDC role was quite small relative to other agencies. Some were small CDC programs but grappling with a huge problem. It wasn’t the existing program parameters that qualify it as a Winnable Battle, but the opportunity to make a difference quickly in the health and safety of the country.